Medicine, Ethics, and Health Policy

Dr. Kathryn Andolsek, Professor in Family Medicine and Community Health

Dr. Don Bradley, Consulting Professor in the Department of Family Medicine and Community Health

The U.S. health system is undergoing a tumultuous transformation amid multiple public health crises including the COVID-19 pandemic, the opioid epidemic, climate change, and pervasive health inequities.

The goals of this course are to understand:

1. Whether we legitimately have a national “health system” or a disparate collection of autonomous and sometimes random parts
2. If the current health system is the best way to optimize health
3. the key principles on which the U.S. health system was established,
4. how health systems function today, and
5. how to help improve the work  of health systems in the future.

Students will review historical milestones and readings.  They will discern with fellow students and faculty the underlying principles on which the U.S. healthcare system (or its components) are based. They will describe current principles and mechanisms of healthcare finance, healthcare delivery, and healthcare policy, and discuss how they affect health systems performance and health outcomes, including  health inequities.

In addition, students will learn and utilize key quality improvement skills and methodologies, systems-based healthcare approaches, behavior change theories and methodologies, project management, and skills to enhance team function and negotiation. External state and local community leaders will provide real world perspectives about their sectors’ role in, and impact on the health system. 

Jehanne Gheith, Associate Professor of Slavic Languages and Literature; Licensed Clinical Social Worker for Duke Hospice

This course examines policy issues in end of life care by considering personal and societal ethical issues. Cross-cultural analysis of end of life care addressing ethical issues among diverse populations: how do different cultural attitudes to dying, death, and health affect end of life care? Ethical issues include discussion of Death with Dignity/Physician Assisted Suicide, access to health care, whether/how long to keep people alive on machines, and how these decisions are made. Course includes perspective and anticipates debate on how art and literature are important for social change. This is a Service Learning course which means that each student will engage in a volunteer placement related to course readings and films. Students will choose from a range of different placements and we will go over this in the first class meeting.

Amir Rezvani, Professor of Psychiatry & Behavioral Sciences; Professor of Psychology & Neuroscience

The major goal of the course is to develop scientific, clinical as well as social perspectives on the issue of addiction and substance abuse.  Students will be able to develop a scientific perspective on the etiology of alcoholism. This course will cover neurobiology of addiction particularly alcoholism.  Students will be presented with the brain disease concept of addiction, co-morbidity of addiction with other mental illness, several models of addiction and appropriate intervention and treatment strategies relevant to each model.  As part of their activities, students will also visit Triangle Residential Options for Substance Abusers (TROSA) in Durham, a unique therapeutic community which is based on principles of self-help and will get to interact with recovering drug addicts and interview them. Furthermore, students will be given the opportunity to hear from several recovering drug addicts coming from different socio-economic and genetic backgrounds.  Furthermore, a family with a child affected with fetal alcohol syndrome will present their daily challenges to students. Students will also get involved in self-designed individual and group projects to better understand the nature of drug addiction and the process of behavioral changes.

Dr. Devdutta Sangvai, Professor in Family Medicine, Pediatrics, and Psychiatry & Behavioral Sciences; Professor in the Program in Education

Do you see yourself as a future leader in healthcare? Maybe as a physician executive? Corporate healthcare CEO? Perhaps a public health advocate? Or a leader in any of the myriad other local and global settings in which leadership so crucial. If your answer is “yes", then this class is right for you!

While much of being a successful leader comes with experience and time, there are fundamental elements that can be taught and explored, especially early in one’s career. Throughout the semester, students will learn about leadership, examine their own leadership traits, and understand the types of leaders that inspire them. We will explore historical examples where leadership was critical to success, and also explore missed opportunities to make a difference. Using case studies and simulation, we will understand how to lead and when to follow. We will draw on the experience of other industries and make a case for healthcare.

Specific objectives include:

• Understand the imperative for leadership in healthcare
• Describe key leadership styles and when to apply each
• Explore the challenges and opportunities for leaders during good times and bad
• Discuss how leadership is about managing people and processes
• Recognize the importance of leading for change
• Identify your own leadership strengths and weaknesses
• Model leadership via simulation exercise(s) and case studies